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1124681572
STACEY MELLON
DOUGLAS, AZ
NPI
1124681572
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
103K00000X Behavior Analyst
(Licence: AZ 1-23-65782)
Enumeration Date
2019-04-20
Last Update Date
2024-11-12
Business Address
STACEY MELLON
530 E 11TH ST UNIT 5
DOUGLAS, AZ 85607-2014
Phone number: 714-393-9136
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Mailing Address
STACEY MELLON
16780 W CAMERON DR
SURPRISE, AZ 85388-3340
Phone number: 714-393-9136
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